Tax Invoice/Bill of Supply/Cash Memo

(Original for Recipient)

Sold By : Billing Address :

COCOBLU RETAIL LIMITED NRUSINGHA PATRA
* Rect/Killa Nos. 38//8/2 min, 192//22/1,196//2/1/1, Sekhpatna , banamalipur, Sekhpatna ,
37//15/1, 15/2,, Adjacent to Starex School, Village banamalipur
- Binola, National Highway -8, Tehsil - Manesar MAJHIHARA, ODISHA, 752103
Gurgaon, Haryana, 122413 IN
IN State/UT Code: 21

PAN No: AAJCC8517E Shipping Address :

GST Registration No: 06AAJCC8517E1ZP NRUSINGHA PATRA
NRUSINGHA PATRA
Sekhpatna , banamalipur, Sekhpatna ,
banamalipur
MAJHIHARA, ODISHA, 752103
IN
State/UT Code: 21
Place of supply: ODISHA
Place of delivery: ODISHA
Order Number: 402-5419151-0593106 Invoice Number : DEL5-3046024
Order Date: 19.09.2022 Invoice Details : HR-DEL5-1271137075-2223
Invoice Date : 19.09.2022

Sl. Unit Net Tax Tax Tax Total

Description Qty
No Price Amount Rate Type Amount Amount
1 Camfoot Men's (1243-1125) Multicolor Casual Sports Running Shoes
6 UK (Set of 2 Pair) | B0979BYFNV ( B0979BYFNV ) ₹231.43 1 ₹231.43 5% IGST ₹11.57 ₹243.00
HSN:64041110
TOTAL: ₹11.57 ₹243.00
Amount in Words:
Two Hundred Forty-three only
For COCOBLU RETAIL LIMITED:

Authorized Signatory
Whether tax is payable under reverse charge - No

Payment Transaction ID: Date & Time: 19/09/2022, 00:51:01 Invoice Value: Mode of Payment:
BlslwO1PmK7uoKsJTKaYriv7LdbjrsRkOBy hrs 243.00 UPI

*ASSPL-Amazon Seller Services Pvt. Ltd., ARIPL-Amazon Retail India Pvt. Ltd. (only where Amazon Retail India Pvt. Ltd. fulfillment center is co-located)

Customers desirous of availing input GST credit are requested to create a Business account and purchase on Amazon.in/business from Business eligible offers

Please note that this invoice is not a demand for payment

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